Nonmedical Social Determinants, Syndemic Conditions, and Suicidal Thoughts and Behaviors in a Treatment-seeking Community Sample: A Latent Class Analysis

Abstract

Objective

Knowledge gaps remain regarding whether syndemic conditions identify treatment-seeking individuals most at risk for suicidal thoughts and behaviors (STB). We employed latent class analysis to: (1) model treatment-seeking individuals’ syndemic conditions, (2) examine latent classes across nonmedical social determinants, and (3) assess associations between class membership and STB.

Method

Participants were 982 individuals presenting at a community mental health clinic between October 2014 and February 2020. The three-step latent class analytic approach was used. Regression analyses were employed to examine nonmedical social determinants and STB outcomes associated with class membership.

Results

Participants were aged 18 to >72 (75.8% White; 76.7% heterosexual; 53.7% cisgender woman; 73.8% earned ≥$20,000 annually). Latent class analysis resulted in a three-class solution. Participants in Class 1 were characterized by low probabilities across syndemic conditions. Class 2 was characterized by high probabilities of anxiety and depression. Class 3 was characterized by high probabilities of eating disorders, anxiety, and depression. Participants of color, sexual minority participants, cisgender women, and those experiencing financial distress were more likely to be in classes characterized by syndemic conditions. Classes characterized by syndemic conditions, relative to no syndemic conditions, were associated with greater risk of STB.

Conclusion

Findings confirm the concentrated clustering of co-occurring syndemic conditions among marginalized groups and highlight differing risks for those considering suicide or who have attempted suicide vs. those engaging in self-harm. Results underscore the need for resource allocation and multilevel interventions targeting syndemic conditions and suicidality for minority populations and those experiencing financial distress.

Keywords:

• Eating disorders
• latent class analysis
• suicidal thoughts and behaviors
• syndemic conditions
• treatment-seeking individuals

DATA AVAILABILITY STATEMENT

Date submitted to Archives of Suicide Research: July 15, 2022.

Additional information

Funding

Jillian Scheer acknowledges support from the National Institute on Alcohol Abuse and Alcoholism (K01AA028239-01A1). The research presented herein is the authors’ own and does not represent the views of the National Institutes of Health.

Notes on contributors

Jillian R. Scheer

Jillian R. Scheer, PhD, and Emily C. Helminen, MS, Department of Psychology, Syracuse University, Syracuse, New York, USA.

Emily C. Helminen

Jillian R. Scheer, PhD, and Emily C. Helminen, MS, Department of Psychology, Syracuse University, Syracuse, New York, USA.

Joshua C. Felver

Joshua C. Felver, PhD, ABPP, Yan Tan Institute, Cornell University, Ithaca, New York, USA; Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, New York, USA.

Deb Coolhart

Deb Coolhart, PhD, Department of Marriage and Family Therapy, Syracuse University, Syracuse, New York, USA.